[Is there an urban factor in asthma and allergy?]. / Existe-t-il un facteur urbain dans l'asthme et l'allergie?

To evaluate if an "urban factor" could be responsible for an increase of asthma and allergic diseases in developed countries, we compared prevalence rates for these conditions in adults living in urban and rural settings. The urban group consisted of 4,008 adults, randomly selected from the 16 districts of the city of Marseille; the rural group consisted of 1,789 adults, representing 85% of the target population living in a small residential town, Trets. The protocol included, after a mass media information, home-visits by public health physicians. These physicians asked a short standardized questionnaire to all adults 18 to 65 years old. Then, in a subgroup of, hay-fever patients, they performed skin tests to grass pollens. The standardized prevalence rates of asthma and related symptoms, and hay fever, was very similar in both settings. Thus, this study does not support the hypothesis that there is a urban factor in asthma and allergic diseases. In the literature, several studies point out a higher prevalence of these diseases in an urban setting. But these studies have been performed several years ago, when there was a larger difference in air pollutants concentrations between urban and rural settings.

Clinical evaluation of the human basophil degranulation test in grass pollen allergic patients.

The reliability of the human basophil degranulation test (HBDT) is still in doubt. We took 20 orchard grass-sensitive patients and 20 non-sensitive subjects and compared the sensitivity of HBDT with skin test and RAST. Eighteen HBDTs were positive in skin test-positive patients. There was also a good correlation with the results of RAST.

[Asthma and pollens]. / Asthme et pollens.

Hay fever was well described by Blackley in 1973. The frequency of pollen asthma may be expressed as a percentage of general frequency of hay fever. The figure of Hagy and Settipane of 21% for students with a mean age of 17.9 years is quoted and ended with different results to the french study by Denis and Perdrizet of 6.5% in students with a mean age of 23 years. One may also express the frequency of asthma in subjects suffering from hay fever which vary greatly with the different plant families. The seasonal rhythm and the oculo-nasal accompaniment are very characteristic. The clinical "scores" of patients have been analysed in parallel with the atmospheric curves of pollen gathered. The current problems of hay fever are particularly: The problem of the penetration of the antigen into the bronchi, the methods of study are reviewed. Little pollen reaches the bronchi. In order to explain this paradox of pollen asthma vagal reflexes from the pharynx are involved and a possible penetration to the bronchi of fragments of pollen and above all aerosols containing allergens (Solomon). Why is it that certain patients have asthma and others only coryza? Perhaps the bronchial reaction is linked to different dose of antigen, to nasal obstruction which makes the subject breath with an open mouth, to different immunological phenomena more intensive in asthmatics than in the subject suffering from coryza (Kaliner) and the bronchial reactivity of certain subjects. In an inverse sense the allergy provokes or increased bronchial reactivity. Finally the early and delayed allergic responses to pollen are a model of what is an oedematous reaginic reaction then inflammatory.

[Use of azlocillin in the treatment of Pseudomonas bronchopulmonary infections]. / Utilisation de l'azlocilline dans le traitement des infections broncho-pulmonaires à Pseudomonas.

Eleven patients with severe bronchopulmonary infection due to Pseudomonas were treated with azlocillin in doses of 250 mg/kg/day. Severe preexisting respiratory diseases, such as bronchopulmonary carcinoma, bronchiectasis or respiratory insufficiency were present in all cases. All patients had been unsuccessfully treated with various antibiotics before they received azlocillin. The pathogenicity of the isolates was assessed by germ counts in sputum. Comparative in vitro sensitivities to carbenicillin and azlocillin were determined by the disc method and by measurement of the minimum inhibitory concentrations in liquid medium. All strains of Pseudomonas aeruginosa isolated were sensitive to azlocillin with minimum inhibitory concentrations of 0.5 to 64 micrograms/ml. When tested against carbenicillin, 4 of the strains were resistant and 1 had intermediate sensitivity. The carbenicillin/azlocillin minimum inhibitory concentrations ratio was usually equal to 4. Clinical results were satisfactory in 7 cases; inadequate response or failure was observed in 4 cases and attributed to the replacement of Pseudomonas by another pathogen (Proteus morganii or Klebsiella pneumoniae). This study suggests that azlocillin is of value in the treatment of bronchopulmonary infections caused by Ps. aeruginosa.

Studies on a new lymphocyte mitogen from pollen aqueous extract: induction of proliferation in human and rodent lymphocytes.

Fraction III (Fr III) mitogen was isolated from the whole aqueous extract (WAE) of plane-tree pollen by Con A-Sepharose chromatography and gel filtration. It stimulated mouse spleen cells, and peripheral blood lymphocytes from plane-tree non-sensitive patients or from cord blood. A 6-day culture gave the best response. The proliferation was not abolished by washing the cells after a short pulse of Fr III given in the initial step but was inhibited by alpha-D-methylmannoside. These results suggested that Fr III bound to a specific site onto spleen cells. This mitogen was not immunogenic in mice and did not bind to human IgE. It induced the proliferation of T lymphocytes in presence of accessory cells and was a polyclonal activator.

Variations in T cell subsets during hyposensitization of grass-sensitive patients with formaldehyde modified extracts: allergoids.

In atopic patients with clinical symptoms of hay fever, changes in T gamma and T mu cells were evaluated during desensitization. A significant increase in T mu and overall in T gamma cells was noted. These results suggested that T cell defect could be restored by desensitization treatment.

Retention of pollen grains in human lung.

The possibility of the penetration of pollen grains into the tracheobronchial tree is still a controversial question. To investigate this phenomenon further two different approaches were conducted: 1) Acetolysis (acidic degradation of organic constituents) of mucosal samples from different levels of the pig respiratory tract showed that specific (plane tree) inhaled pollens were not found beyond the main bronchi. 2) In contrast, a noticeable number of pollens were present in acetolyzed residues of lung surgical samples; this was shown to be due to contamination. In the first approach this problem was avoided; however, the analysis of surgical samples could be a valuable technique if suitable controls were included.

In vitro evaluation of blocking antibodies by RAST interference during pollen desensitization: role of the IgG fraction.

RAST interference was used to study the changes in blocking antibodies during hyposensitization. At the onset of desensitization blocking antibodies levels were correlated to IgE antibody titers. They progressively rose during the treatment. IgG isolated by adsorption onto protein A Sepharose were only a part of blocking antibodies. The isolated antibodies gave 80% of RAST interference values. Results showed that RAST interference may be used routinely to determine changes of immunological parameters of immunotherapy.

[Bronchial response to allergens after controlled NO2 exposure (author's transl)]. / Réponse bronchique aux allergènes après exposition controlée au dioxyde d'azote.

The bronchial response to inhaled grass pollen (assessed by specific airway resistance, SRaw, measurements) was determined in seven allergic patients after each had spent 1 hour in an exposure chamber breathing on one occasion unpolluted air and on a separate occasion (one week interval) a mixture of air and nitrogen dioxide (NO2, 207 micrograms/m3). Sequences of exposure to unpolluted air and to NO2 were randomized in a single-blind fashion. No significant change in baseline SRaw or in the response to antigen was observed after NO2 exposure.

[Frequency of chronic rhinitis in a population of young adults. Influence of pollen allergy and tobacco addiction (author's transl)]. / Fréquence des rhinites chroniques dans une population d'adultes jeunes. Influence de l'allergie pollinique et du tabagisme.

A survey of 27 604 sujets aged mostly between 17 and 19 revealed that 33.5% of them had a regular nasal obstruction and that 13.6% repeated sneezing fits. Prevalence of nasal manifestations related to an allergy to graminaceae pollen was estimated at 5%. Besides there was a close relationship between the chronic nasal symptomatology and the smoking habits of the subjects concerned.

[Asthma and environment (author's transl)]. / Asthme et environnement.

Asthma which includes an important bronchial hyper-reactivity to several substances is closely linked to environmental factors. Atmospheric allergens are among the best known of these factors. Some and the most numerous, like pollen, are natural. Others like isocyanates are artificial and mostly the cause of professional accidents. The noxious effect of air pollution on airways has been clearly established by the numerous observations compiled over half a century. As far as asthma is concerned, the bronchoconstricting effect of pollutants inhaled at high doses is well known. Numerous epidemiological studies and tests performed in laboratories have also revealed the action of different pollutants inhaled at "realistic" concentrations. The relationship between asthma and climatic environment appears more difficult to define and the objective facts which could play a part in these relations are few and contradictory.

A prospective national study of the safety of immunotherapy.

A prospective study was made in France to determine the frequency, nature, causes and consequences of systemic reactions occurring during specific immunotherapy. One hundred and fifty five reactions were recorded in 151, 997, injections given to 19,739 patients; a percentage of 0.1. It was higher with pollen extracts (0.2%) and practically nil with other extracts (house dust, Dermatophagoides, insect body, bacteria). Asthma, spasmodic rhinitis and urticaria were the most frequent, 80% of systemic reactions. In 59% no explanation could be found. The main known causes of adverse reactions were excessive doses of antigen, improper timing of treatment or incorrect technique of injection. After appropriate treatment the immunotherapy was continued in nearly 90% of the cases. Specific immunotherapy with the majority of extracts now being used, namely adsorbed extracts, is not dangerous but it must be precisely and cautiously done because errors are responsible for nearly 50% of the recorded systemic reactions.

Pollen-allergen IgE response in the inbred rat. Regulation of allergen P-IgE antibodies in high and low responders by suppressive factors.

Cyclophosphamide treatment (100 mg/kg) significantly increased the IgE response to plane-tree allergen P in low-responder strains of rats. A suppressive serum was obtained by injection of CFA in normal low-responder strains. The injection of this serum 2 days after cyclophosphamide treatment and 1 day prior to primary immunization, reversed the cyclophosphamide-enhanced IgE antibodies response without affecting the IgG2a levels. This effect is strain specific.

[Are rat alveolar macrophages capable of phagocytizing pollen grains?]. / Les macrophages alvéolaires de rat peuvent-ils phagocyter les grains de pollen?

Plane-tree pollen grains were incubated in vitro with alveolar macrophages from inbred Rats, and the possibility of phagocytosis was investigated. No phagocytosis was observed even after 48 hrs incubation. But alveolar cells were bound to pollen grains generally at the apertures. This binding did not require the Fc receptor on the macrophage membrane.

[Objective immunological and clinical data observed during an altitude cure at Briançon in asthmatic children allergic to house dust and dermatophagoides (author's transl)]. / Données objectives cliniques et immunologiques observées au cours d'une cure d'altitude à Briançon chez des enfants asthmatiques allergiques à la poussière de maison et à dermatophagoides.

In 42 asthmatic children with positive intradermal skin tests to Dermatophagoides pteronyssinus and domestic dust, assays of total and specific IgE were done at regular intervals during a prolonged (9 months) stay at high altitude (Briançon 1300 m). Geometric mean of total IgE (1047 UI/ml at the beginning) dropped to 40% (p less than 0,001) after the stay. In the same way, specific IgE to dermatophagoides, to domestic dust and to grass pollen dropped during the stay (p less than 0,001). On the other hand, other immunoglobulins (IgG, IgA and IgM) did not undergo any significant variations. Clinical improvement of asthma in these allergic children was observed at the first week of stay and could be maintained without drugs during all the 9 months in altitude. Rather than a consequence of an aspecific effect of altitude on the biosynthesis of reaginic antibodies, it would seem that the very consistent fall in total and specific IgE and the clinical improvement should be interpreted as the result of removal from antigenic provocation into a hypoallergenic atmosphere.